What is the difference between civil servant social security and employee social security?

The difference between civil servant social security and employee social security;

1. Insured object

Civil servants' medical insurance is mainly aimed at civil servants and their families, including staff of public departments such as state organs, institutions, public hospitals and public schools. The object of employee medical insurance is enterprise employees and their families, including employees and retirees of enterprises, institutions, social organizations and other organizations.

2. Scope of protection

The coverage of civil servants' medical insurance and employees' medical insurance is also different. Civil servant medical insurance mainly includes basic medical insurance, serious illness medical insurance and supplementary medical insurance, covering a wide range. Employee medical insurance mainly includes basic medical insurance and serious illness medical insurance, and its coverage is relatively narrow.

3. Payment standard

The payment standards of civil servant medical insurance and employee medical insurance are also different. The payment standard of civil servant medical insurance is formulated by the government and generally paid by units and individuals. The payment standard of employee medical insurance is that enterprises and individuals pay together, and the proportion of payment is generally more enterprises and less individuals.

4. Proportion of reimbursement

The reimbursement ratio of civil servant medical insurance and employee medical insurance is also different. The proportion of civil servants' medical insurance reimbursement is generally high, generally above 80%, and in some areas it can even reach 100%. The proportion of medical insurance reimbursement for employees is relatively low, generally between 60% and 80%.

To sum up, civil servants' medical insurance and employees' medical insurance are both medical insurance systems established to protect people's health care rights and interests, but there are certain differences between them in terms of insured objects, coverage, payment standards and reimbursement ratio.

Legal basis:

Article 23 of People's Republic of China (PRC) Social Insurance Law

Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

Article 24

The state establishes and improves the new rural cooperative medical system.

Measures for the administration of the new rural cooperative medical system shall be formulated by the State Council.

Article 25

The state establishes and improves the basic medical insurance system for urban residents.

The basic medical insurance for urban residents combines individual contributions with government subsidies.

People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.

Article 26

The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Article 27

Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state if they reach the statutory retirement age and the accumulated payment has reached the fixed number of years stipulated by the state; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.

Article 28

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.

Article 30

The following medical expenses are not included in the payment scope of the basic medical insurance fund:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.

Article 31

According to the needs of management services, social insurance agencies can sign service agreements with medical institutions and pharmaceutical business units to standardize medical service behavior.

Medical institutions shall provide reasonable and necessary medical services for the insured.

Article 32

If an individual is employed across the overall planning area, his basic medical insurance relationship will be transferred accordingly, and the payment period will be calculated cumulatively.